Abstract: Diabetes and its complications have huge disease burdens globally especially in developing countries. Morbidity and mortality from diabetes is very high in Nigeria due to poor management and noncompliance with global guidelines. Many studies have observed that diabetes management in Nigeria is suboptimal with very poor outcomes. The purpose of this study is to identify factors that are responsible for the poor diabetes management outcome in Nigeria in other to find solutions to prevent needless deaths and disabilities related to the disease. Study participants consisted of 47 diabetic patients receiving treatment at Federal Medical Center and General Hospital, Umuguma both in Owerri Local Government Area of Imo State of Nigeria. A cross sectional descriptive survey and face to face interviews were conducted to illicit information from the subjects. Results showed that majority of subjects (42.5%) had secondary education, all subjects earned even < $2/day and had a high mean BMI of 28.8. While 80.9% of subjects never had a self blood glucose monitoring kit, 82.7% could not afford the kit, only 19.1% ever engaged in self glucose monitor and only 6.4% has had an HbA1c screening before. Majority (68%) paid for their treatment and care. Majority of subjects (93.6%) lacked basic knowledge of diabetes management or care and reported inability to visit the doctor except when manifesting serious symptoms or complications. Also many subjects (46.8%) had used some sort of herbs or concoctions as medical remedies for their diabetes. The study also recorded 0% interaction rate between health care workers and diabetes patients outside the health facility. Based on these findings, the study concluded that the health care delivery system in Nigeria is grossly inadequate to handle the various intricate lifelong management issues of diabetes and therefore recommends among others the provision and enforcement of policy and guidelines for diabetes management for all healthcare professionals and facilities will ensure that every healthcare provider follows the guidelines for diabetes management as recommended by International Diabetes Federation.